The Impact of Employee Wellness Programs

There is great public and private interest in the use of workplace wellness programs to reduce health care spending, improve health outcomes, and enhance productivity for employees. However, there is little rigorous evidence on the effects of wellness programs. This study partners with a large multi-state U.S. employer (BJ's Wholesale Club) and an experienced wellness vendor (Wellness Workdays) to evaluate a multi-prong workplace wellness program, including components such as nutrition counseling, fitness challenges, and stress management workshops. The wellness program will be delivered by a team of experts including Registered Dieticians, and will include financial rewards for participation. The program will be available to employees in initially 20 of BJ's 200 worksites, and later expanded to 25 worksites. These worksites have been randomly selected, allowing a randomized controlled trial evaluation of the effects of the wellness program. Data will be collected on a wide array of outcomes from multiple sources, including on-site biometric screenings and surveys, employment records, and health insurance claims for employees at both treatment and control worksites.

Study Overview

• Status: Completed
• Conditions: Health Behavior; Disease, Chronic
• Intervention / Treatment: Behavioral: Workplace wellness program

• Study Type: Interventional
• Enrollment (Actual): 48664
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Employed in one of BJ's clubs during the period of the intervention

Exclusion Criteria:

• Not employed in one of BJ's clubs during the period of the intervention

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment; Employees at treatment worksites will be given access to workplace wellness programming. Participation by employees will be voluntary, but all employees at treatment sites will be considered as part of the treatment group. Employees will also be invited to complete on-site biometric assessments and questionnaires. Data from secondary data sources (including employment records and health insurance claims) will be collected for employees at all BJ's worksites.	Behavioral: Workplace wellness program; Multi-prong workplace wellness program, with components such as nutrition counseling, fitness challenges, and stress management workshops, including supports and incentives.
No Intervention: Primary Control; Employees at primary control worksites will be invited to complete on-site biometric assessments and questionnaires, but will not have access to the workplace wellness programming. Data from secondary data sources (including employment records and health insurance claims) will be collected for employees at all BJ's worksites.
No Intervention: Secondary Control; Employees at secondary control worksites will not participate in in-person screenings or questionnaires, and will not have access to workplace wellness programming. Data from secondary data sources (including employment records and health insurance claims) will be collected for employees at all BJ's worksites.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical activity	Regular exercise, number of hours sitting per day, and actively managing weight, as indicated in responses to survey questions	Primary data collected at 18 months and 30 months after initiation of intervention
Obesity	Body Mass Index>=30, calculated from measured height and weight	Primary data collected at 18 months and 30 months after initiation of intervention
Absenteeism	Number of sick or personal days as a share of total days employed, from employment records	Administrative records from 3 years spanning intervention
Health care spending	Dollars spent on health care for employees covered by employer-sponsored insurance, from claims records	Administrative records from 3 years spanning intervention

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood pressure	Systolic blood pressure, measured	Primary data collected at 18 months and 30 months after initiation of intervention
Depression	Unmanaged depression, as indicated in responses to survey questions	Primary data collected at 18 months and 30 months after initiation of intervention
Tenure	Duration of employment in days, from employment records	Administrative records from 3 years spanning intervention
Job performance	Numerical performance rating from annual review, from employment records	Administrative records from 3 years spanning intervention
Health care spending (i.e. dollars spent)	Dollars spent on health care and prescription drugs for employees covered by employer-sponsored insurance, decomposed into spending on inpatient, outpatient, emergency department, and prescription drugs, from claims records	Administrative records from 3 years spanning intervention
Health care utilization (i.e. number of doctor visits, hospitalizations, or medications)	Health care encounters and prescription drugs for employees covered by employer-sponsored insurance, decomposed into inpatient, outpatient, emergency department, and prescription drugs, from claims records	Administrative records from 3 years spanning intervention
Nutrition management	Affirmative engagement in active efforts to improve nutrition, as indicated in responses to survey questions	Primary data collected at 18 months and 30 months after initiation of intervention
Stress management	Unmanaged stress and stress at work, as indicated in responses to survey questions	Primary data collected at 18 months and 30 months after initiation of intervention
Screenings and exams	Percent of recommended tests received, as indicated in responses to survey questions	Primary data collected at 18 months and 30 months after initiation of intervention
Tobacco use	Smoking, as indicated in responses to survey questions	Primary data collected at 18 months and 30 months after initiation of intervention
Health and wellbeing	Short form 8 (SF-8) physical and mental summary scores, as indicated in responses to survey questions. Each question of the SF-8 uses a 5- or 6-point Likert scale. Its standardized scoring system combines responses into a score that can be interpreted as a continuous variable (analogous to a 0-100 scale), with higher scores denoting better self-reported health.	Primary data collected at 18 months and 30 months after initiation of intervention
Blood glucose	Blood glucose, measured	Primary data collected at 18 months and 30 months after initiation of intervention
Cholesterol	Total cholesterol and high-density lipoprotein (HDL), measured	Primary data collected at 18 months and 30 months after initiation of intervention

Collaborators and Investigators

• Sponsor: Harvard School of Public Health (HSPH)
• Collaborators: University of Chicago; National Institute on Aging (NIA); Abdul Latif Jameel Poverty Action Lab; Robert Wood Johnson Foundation
• Investigators: Principal Investigator: Zirui Song, MD, PhD, Harvard Medical School (HMS and HSDM)

Publications and helpful links

General Publications

• Song Z, Baicker K. Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial. JAMA. 2019 Apr 16;321(15):1491-1501. doi: 10.1001/jama.2019.3307. Erratum In: JAMA. 2019 Apr 17;:

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2015
• Primary Completion (Actual): October 1, 2018
• Study Completion (Actual): June 1, 2021

Study Registration Dates

• First Submitted: May 23, 2017
• First Submitted That Met QC Criteria: May 24, 2017
• First Posted (Actual): May 30, 2017

Study Record Updates

• Last Update Posted (Actual): September 9, 2021
• Last Update Submitted That Met QC Criteria: September 7, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: Prevention; Wellness
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Chronic Disease
• Other Study ID Numbers: Wellness 14-3141; R01AG050329 (U.S. NIH Grant/Contract); P30AG012810 (U.S. NIH Grant/Contract); 72611 (Other Grant/Funding Number: Robert Wood Johnson Foundation); AEARCTR-0000586 (Registry Identifier: American Economic Association Trial Registry)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No